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Publisher: Elsevier   (Total: 3042 journals)

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Showing 1 - 200 of 3042 Journals sorted alphabetically
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 19, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 16, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 81, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 23, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 27, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 328, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription  
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 205, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 9, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 2)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 22, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 5, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 3)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 5)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 20)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 124, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 16, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 25, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 10, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 21, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 24, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 8, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 28, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 4)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 39, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 25, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 40, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 45, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 14)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 20, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 24)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 34, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 4)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 5, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 7, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 21, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 7, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 18)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 19, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 58)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Research     Full-text available via subscription   (Followers: 339, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 6, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 29, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 15)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 43, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 308, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 7, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 422, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 15, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 38, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 50, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 10, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 6)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access  
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 5, SJR: 0.776, h-index: 35)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 6, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 5)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 3)
American Heart J.     Hybrid Journal   (Followers: 47, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 44, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 34, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 6, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 15, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 30, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 24, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 44, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 179, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 54, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 2)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 23, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 23, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 21, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 33, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 53, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 5)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 2, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 38, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 160, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 10)
Anesthésie & Réanimation     Full-text available via subscription  
Anesthesiology Clinics     Full-text available via subscription   (Followers: 21, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 153, SJR: 1.907, h-index: 126)
Animal Feed Science and Technology     Hybrid Journal   (Followers: 5, SJR: 1.151, h-index: 83)
Animal Reproduction Science     Hybrid Journal   (Followers: 5, SJR: 0.711, h-index: 78)
Annales d'Endocrinologie     Full-text available via subscription   (SJR: 0.394, h-index: 30)
Annales d'Urologie     Full-text available via subscription  
Annales de Cardiologie et d'Angéiologie     Full-text available via subscription   (SJR: 0.177, h-index: 13)
Annales de Chirurgie de la Main et du Membre Supérieur     Full-text available via subscription  
Annales de Chirurgie Plastique Esthétique     Full-text available via subscription   (Followers: 2, SJR: 0.354, h-index: 22)
Annales de Chirurgie Vasculaire     Full-text available via subscription   (Followers: 1)

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Journal Cover American Journal of Ophthalmology
  [SJR: 2.803]   [H-I: 148]   [54 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0002-9394
   Published by Elsevier Homepage  [3042 journals]
  • Anisometropia at Age 5 Years After Unilateral Intraocular Lens
           Implantation During Infancy in the Infant Aphakia Treatment Study
    • Authors: David Weakley; George Cotsonis; M. Edward Wilson; David A. Plager; Edward G. Buckley; Scott R. Lambert
      Pages: 1 - 7
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): David Weakley, George Cotsonis, M. Edward Wilson, David A. Plager, Edward G. Buckley, Scott R. Lambert
      Purpose To report the prevalence of anisometropia at age 5 years after unilateral intraocular lens (IOL) implantation in infants. Design Prospective randomized clinical trial. Methods Fifty-seven infants in the Infant Aphakia Treatment Study (IATS) with a unilateral cataract were randomized to IOL implantation with an initial targeted postoperative refractive error of either +8 diopters (D) (infants 28 to <48 days of age) or +6 D (infants 48–210 days of age). Anisometropia was calculated at age 5 years. Six patients were excluded from the analyses. Results Median age at cataract surgery was 2.2 months (interquartile range [IQR], 1.2, 3.5 months). The mean age at the age 5 years follow-up visit was 5.0 ± 0.1 years (range, 4.9–5.4 years). The median refractive error at the age 5 years visit of the treated eyes was −2.25 D (IQR −5.13, +0.88 D) and of the fellow eyes +1.50 D (IQR +0.88, +2.25). Median anisometropia was −3.50 D (IQR −8.25, −0.88 D); range −19.63 to +2.75 D. Patients with glaucoma in the treated eye (n = 9) had greater anisometropia (glaucoma, median −8.25 D; IQR −11.38, −5.25 D vs no glaucoma median −2.75; IQR −6.38, −0.75 D; P = .005). Conclusions The majority of pseudophakic eyes had significant anisometropia at age 5 years. Anisometropia was greater in patients that developed glaucoma. Variability in eye growth and myopic shift continue to make refractive outcomes challenging for IOL implantation during infancy.

      PubDate: 2017-06-12T09:26:32Z
      DOI: 10.1016/j.ajo.2017.05.008
      Issue No: Vol. 180 (2017)
       
  • Relationship Between Visual Acuity and Retinal Thickness During
           Anti–Vascular Endothelial Growth Factor Therapy for Retinal Diseases
    • Authors: William C. Ou; David M. Brown; John F. Payne; Charles C. Wykoff
      Pages: 8 - 17
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): William C. Ou, David M. Brown, John F. Payne, Charles C. Wykoff
      Purpose To investigate the relationship between best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in eyes receiving ranibizumab for 3 common retinal diseases. Design Retrospective analysis of clinical trial data. Methods Early Treatment Diabetic Retinopathy Study BCVA and spectral-domain optical coherence tomography–measured CRT of 387 eyes of 345 patients enrolled in 6 prospective clinical trials for management of neovascular age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO) were evaluated by Pearson correlation and linear regression. Results At baseline, there was a small correlation between BCVA and CRT in pooled AMD trial data (r = −0.24). A medium correlation was identified in pooled DME trial data (r = −0.42). No correlation was found in pooled RVO trial data. At month 12, no correlation was found between changes from baseline in BCVA and CRT in pooled AMD trial data. Medium correlations were identified in both pooled DME (r = −0.45) and pooled RVO (r = −0.35) trial data at month 12. Changes in BCVA and CRT associated with edema recurrence upon transition from monthly to pro re nata (PRN) dosing were correlated in AMD (r = −0.27) and RVO (r = −0.72) trials, but not in DME trial data. Conclusion DME demonstrated a convincing relationship between BCVA and CRT. Correlations appear to be more complex in AMD and RVO. At the inflection point between monthly and PRN dosing, when recurrence of edema is anticipated in many patients, CRT appears strongly correlated with loss of BCVA in RVO.

      PubDate: 2017-06-12T09:26:32Z
      DOI: 10.1016/j.ajo.2017.05.014
      Issue No: Vol. 180 (2017)
       
  • Orbital and Orbitocranial Trauma From Pencil Fragments: Role of Timely
           Diagnosis and Management
    • Authors: Won-Kyung Cho; Audrey C. Ko; Habibullah Eatamadi; Abdelqadir Al-Ali; Jean-Paul Abboud; Don O. Kikkawa; Bobby S. Korn
      Pages: 46 - 54
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): Won-Kyung Cho, Audrey C. Ko, Habibullah Eatamadi, Abdelqadir Al-Ali, Jean-Paul Abboud, Don O. Kikkawa, Bobby S. Korn
      Purpose To emphasize the importance of early detection and radiologic evaluation of retained organic foreign bodies (FBs) in orbital or orbitocranial penetrating injuries by pencil. Design Retrospective case series. Methods A retrospective chart review of patients who had penetrating orbital or orbitocranial trauma at 2 tertiary hospitals was conducted. Patients whose mechanism of injury was penetrating trauma by pencil were included. The patients' demographics, time between initial trauma and detection of foreign body, radiologic images, and resulting sequelae were reviewed. Results Four patients were included in this study. All patients were male; 3 were less than 2 years of age and 1 was 34 years old. Accidents were witnessed in 2 cases, and initial detections of FBs were delayed in 3 cases, from 2 days to 7 weeks. Three cases involved the right orbit. Computed tomography (CT) imaging of the head demonstrated penetration of the orbital walls in 3 cases. Three-dimensional CT scans were used to differentiate the penetrating graphite pencil fragments from the orbital wall, and catheter angiography was used in 1 case of suspected orbital apex penetration. Vision was lost in 1 patient while other severe neurologic deficits were fully recovered after removal of FB. Conclusions Penetrating injury by pencils to the periorbital structures and delayed detection of retained pencil fragments can result in threat to life and vision. Radiologic examinations are essential to the detection of these retained FBs. Prompt detection and removal of the FBs within 48 hours and treatment with antibiotics can save vision and life.

      PubDate: 2017-06-16T09:30:19Z
      DOI: 10.1016/j.ajo.2017.05.018
      Issue No: Vol. 180 (2017)
       
  • Choroidal Changes Associated With Subretinal Drusenoid Deposits in
           Age-related Macular Degeneration Using Swept-source Optical Coherence
           Tomography
    • Authors: Inês Laíns; Jay Wang; Joana Providência; Steven Mach; Pedro Gil; João Gil; Marco Marques; Grayson Armstrong; Shady Garas; Patrícia Barreto; Ivana K. Kim; Demetrios G. Vavvas; Joan W. Miller; Deeba Husain; Rufino Silva; John B. Miller
      Pages: 55 - 63
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): Inês Laíns, Jay Wang, Joana Providência, Steven Mach, Pedro Gil, João Gil, Marco Marques, Grayson Armstrong, Shady Garas, Patrícia Barreto, Ivana K. Kim, Demetrios G. Vavvas, Joan W. Miller, Deeba Husain, Rufino Silva, John B. Miller
      Purpose To compare choroidal vascular features of eyes with and without subretinal drusenoid deposits (SDD), using swept-source optical coherence tomography (SS OCT). Design Multicenter, cross-sectional study. Methods We prospectively recruited patients with intermediate age-related macular degeneration (AMD), without other vitreoretinal pathology. All participants underwent complete ophthalmic examination, color fundus photography (used for AMD staging), and spectral-domain OCT (to evaluate the presence of SDD). SS OCT was used to obtain automatic macular choroidal thickness (CT) maps, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) sectors. For data analysis, we considered mean choroidal thickness as the arithmetic mean value of the 9 ETDRS sectors. SS OCT en face images of choroidal vasculature were also captured and converted to binary images. Choroidal vascular density (CVD) was calculated as a percent area occupied by choroidal vessels in a 6-mm-diameter submacular circular. Choroidal vessel volume was calculated by multiplying the average CVD by macular area and CT. Multilevel mixed linear models (to account for the inclusion of 2 eyes of same subject) were performed for analysis. Results We included 186 eyes (n = 118 subjects), 94 (50.5%) presenting SDD. Multiple regression analysis revealed that, controlling for age, eyes with SDD presented a statistically thinner mean CT (ß = −21.9, P = .006) and CT in all the individual ETDRS fields (ß ≤ −18.79, P ≤ .026). Mean choroidal vessel volume was also significantly reduced in eyes with SDD (ß = −0.003, P = .007). No significant associations were observed with mean CVD. Conclusion In subjects with intermediate AMD, choroidal thickness and vessel volume are reduced in the presence of subretinal drusenoid deposits.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.021
      Issue No: Vol. 180 (2017)
       
  • Classification of Fluorescein Breakup Patterns: A Novel Method of
           Differential Diagnosis for Dry Eye
    • Authors: Norihiko Yokoi; Georgi As. Georgiev; Hiroaki Kato; Aoi Komuro; Yukiko Sonomura; Chie Sotozono; Kazuo Tsubota; Shigeru Kinoshita
      Pages: 72 - 85
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): Norihiko Yokoi, Georgi As. Georgiev, Hiroaki Kato, Aoi Komuro, Yukiko Sonomura, Chie Sotozono, Kazuo Tsubota, Shigeru Kinoshita
      Purpose To investigate the relationship between fluorescein breakup patterns (FBUPs) and clinical manifestations in dry eye cases. Design Cross-sectional study. Methods In 106 eyes of 106 subjects (19 male, 87 female; mean age: 64.2 years), FBUPs were categorized into 1 of the following 5 break (B) types: area (AB, n = 19); spot (SB, n = 22); line (LB, n = 24); dimple (DB, n = 19); random (RB, n = 22 eyes); and dry eye–related symptoms using the visual analog scale (VAS, 100 mm = maximum), tear meniscus radius (TMR, mm), tear film lipid layer interference grade (IG) (grades 1–5; 1 = best) and spread grade (SG) (grades 1–4; 1 = best), tear film noninvasive breakup time (NIBUT, seconds), fluorescein breakup time (FBUT, seconds), corneal-epithelial damage (CED) score (15 points = maximum), ocular surface epithelial damage (OSED) score (9 points = maximum), and the Schirmer 1 test (ST1, mm) were examined and compared between each FBUP. Results In each FBUP, eye dryness and fatigue were the severest symptoms. Characteristic symptoms were sensitivity to light, heavy eyelids, pain, foreign body sensation, difficulty opening the eye, and discharge for AB, heavy eyelids for SB, and foreign-body sensation for LB. Statistically significant differences were found in TMR (AB-SB, -DB, and -RB; LB-RB), IG (AB-all other FBUP; LB-SB and -DB), and SG (AB-all other FBUPs), FBUT (AB-LB, -DB, and -RB; SB-DB and -RB; LB-RB; DB-RB), and NIBUT (AB-all other FBUPs; SB-DB and-RB, and LB-RB), CED (AB-all other FBUPs; LB-SB, -DB, and -RB) and OSED (AB-SB, -LB, and -DB; LB-SB, -DB, and -RB), and ST1 (AB-SB, -DB, and -LB) (P < .05 in each comparison). Conclusions The 5 different FBUPs constituted different groups, reflecting different pathophysi-ologies.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.022
      Issue No: Vol. 180 (2017)
       
  • Practice Patterns Among Eye Care Providers at US Teaching Hospitals With
           Regard to Assessing and Educating Patients About Smoking
    • Authors: Zachary C. Landis; Ramunas Rolius; Ingrid U. Scott
      Pages: 86 - 90
      Abstract: Publication date: August 2017
      Source:American Journal of Ophthalmology, Volume 180
      Author(s): Zachary C. Landis, Ramunas Rolius, Ingrid U. Scott
      Purpose To investigate practice patterns of eye care providers at academic medical centers in the United States (US) with regard to assessing patients' smoking status and exposure, educating patients regarding ocular risks of smoking, and counseling patients about smoking cessation. Design Cross-sectional survey. Methods An anonymous survey including multiple choice and Likert-style questions was constructed on http://www.surveymonkey.com and emailed to the coordinators of all 113 US ophthalmology residency programs, with a request to forward to all faculty, fellows, residents, and optometrists at their institution. Main outcome measures include proportion of eye care providers who assess patients' smoking status, educate patients regarding ocular risks of smoking, and discuss with patients smoking cessation options. Results Of the 292 respondents, 229 (78%) “always” or “periodically” ask patients about their smoking status, 251 (86%) “seldom” or “never” ask patients about secondhand smoke exposure, 245 (84%) “always” or “periodically” educate patients about ocular diseases associated with smoking, 142 (49%) “seldom” or “never” ask patients who smoke about their willingness to quit smoking, and 249 (85%) “seldom” or “never” discuss potential methods and resources to assist with smoking cessation. Conclusions Most eye care providers assess patients' smoking status and educate patients regarding ocular risks of smoking. However, approximately half do not ask, or seldom ask, about patients' willingness to quit smoking, and most do not discuss smoking cessation options.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.023
      Issue No: Vol. 180 (2017)
       
  • Reduced Free Communication of the Subarachnoid Space Within the Optic
           Canal in the Human
    • Authors: Mikee Liugan; Zhaoyang Xu; Ming Zhang
      Pages: 25 - 31
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Mikee Liugan, Zhaoyang Xu, Ming Zhang
      Purpose Recent studies in patients demonstrated that cerebrospinal fluid does not flow continuously between the intracranial subarachnoid space (SAS) and the space around the optic nerve in the orbit. Its anatomic basis remains elusive. The objective of this study was to use a novel anatomic technology, the epoxy sheet plastination, to reveal the configuration of the fibrous structures within the optic canal and their relationship with the optic nerve, SAS, and ophthalmic artery. Design A human cadaveric study. Methods Nine cadaveric heads (subject age 54–87 years) without optic neuropathy were prepared as sets of transverse, coronal, and sagittal plastinated sections. Three of them were pretreated with hematoxylin staining via the SAS irrigation before sectioning and plastination. The prepared sections were examined under a stereoscope and a confocal microscope. Results The results showed that (1) the pia and arachnoid maters merged within the optic canal, (2) a dense trabecular mesh network was distributed in the orbital part of the canal, and (3) some optic nerve sheath (ONS) fibers intermingled with the tendinous fibers of the extraocular muscles and attached to the periosteum of the sphenoid bone, rather than entirely continuing with the inner layer of the dura mater. Conclusions This study identified and traced the fibrous components within the optic canal and revealed their nature, architecture, and relationship with surroundings and concluded that in the human, free communication of the SAS between the intracranial cavity and ONS was significantly reduced.

      PubDate: 2017-05-07T15:15:31Z
      DOI: 10.1016/j.ajo.2017.04.012
      Issue No: Vol. 179 (2017)
       
  • Stem Cells for Retinal Disease: A Perspective on the Promise and Perils
    • Authors: Rajesh C. Rao; Vaidehi S. Dedania; Mark W. Johnson
      Pages: 32 - 38
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Rajesh C. Rao, Vaidehi S. Dedania, Mark W. Johnson
      Purpose To summarize key concepts, as well as early safety and efficacy signals from clinical trials, for stem/progenitor cell–based interventions for retinal disease. Design Interpretive essay. Methods Review and synthesis of selected recent reports of stem/progenitor cell–based approaches for retinal disease, with interpretation and perspective. Results Stem/progenitor cell–based interventions represent a novel class of potential therapies for retinal diseases, such as age-related macular degeneration and inherited retinal dystrophies, aoong others. Sources include pluripotent stem cells and fetal and postnatal tissues. Two mechanisms of “rescue” have been proposed: regenerative or trophic. Although pluripotent and fetal sourced-cell types have been tested in preclinical animal models of retinal disease, many postnatal stem/progenitor cell populations currently in trial do not have preclinical safety or efficacy data. Some early-phase trials of cell therapies suggest acceptable safety profiles. Other reports, involving some types of autologous, nonocular cell sources, have been linked to severe, blinding complications. Larger trials will be needed to determine short-term and long-term safety and efficacy of these cell-based interventions. Conclusions Stem/progenitor cell–based interventions have the potential to address blinding retinal diseases that affect hundreds of millions worldwide. Yet no Food and Drug Administration–approved stem cell therapies for retinal disease exist. Although some early-phase trial data are promising, reports of blinding complications from cell interventions remain troubling. It is paramount to apply a strong level of scientific rigor toward a well-planned, step-wise sequence of preclinical and clinical studies, to determine whether this class of potential therapies will be safe and effective for individuals with retinal diseases.

      PubDate: 2017-05-07T15:15:31Z
      DOI: 10.1016/j.ajo.2017.04.007
      Issue No: Vol. 179 (2017)
       
  • Causes of Diplopia in Patients With Epiretinal Membranes
    • Authors: Kevin K. Veverka; Sarah R. Hatt; David A. Leske; William L. Brown; Raymond Iezzi; Jonathan M. Holmes
      Pages: 39 - 45
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Kevin K. Veverka, Sarah R. Hatt, David A. Leske, William L. Brown, Raymond Iezzi, Jonathan M. Holmes
      Purpose To describe the causes of diplopia in patients with an epiretinal membrane (ERM) and presenting diplopia. Design Retrospective observational case series. Methods We reviewed patients diagnosed with an ERM, who had been seen by both retinal and strabismus specialists in a tertiary medical center. Data recorded: orthoptic evaluation, retinal misregistration (optotype-frame test, and synoptophore central peripheral superimposition slides at 5 and 10 degrees), and cause of any diplopia (retinal misregistration vs strabismus vs optical/refractive error). We defined central-peripheral rivalry–type diplopia as presenting symptomatic diplopia with evidence of retinal misregistration, and where other causes did not fully explain diplopia. The frequency of each cause of diplopia in patients with ERM was determined. Results Of 50 patients with ERM, 25 had symptomatic diplopia and 25 had no diplopia. Eleven of 25 diplopic patients (44%) had retinal misregistration as the sole cause (central-peripheral rivalry–type diplopia), 7 (28%) strabismus (1 of 7 initally appeared to have central-peripheral rivalry–type diplopia), 1 (4%) optical/refractive error (monocular diplopia), 2 (8%) mixed retinal misregistration (central-peripheral rivalry–type diplopia) and strabismus, and for 4 (16%) diplopia cause was indeterminate. Unexpectedly, 15 of 25 patients without diplopia (60%) had evidence of retinal misregistration. Conclusions Patients with ERM and presenting diplopia may have 1 of several causes of diplopia, most commonly retinal misregistration (central-peripheral rivalry–type diplopia). Nevertheless, diplopic patients with retinal misregistration may also have treatable strabismus or optical/refractive error as the primary barrier to single vision and therefore many potential barriers to single vision should be considered.

      PubDate: 2017-05-12T15:23:25Z
      DOI: 10.1016/j.ajo.2017.04.014
      Issue No: Vol. 179 (2017)
       
  • Anterior Chamber Angle and Anterior Segment Structure of Eyes in Children
           With Early Stages of Retinopathy of Prematurity
    • Authors: Shirley H.L. Chang; Yung-Sung Lee; Shiu-Chen Wu; Lai-Chu See; Chia-Chi Chung; Meng-Lin Yang; Chi-Chun Lai; Wei-Chi Wu
      Pages: 46 - 54
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Shirley H.L. Chang, Yung-Sung Lee, Shiu-Chen Wu, Lai-Chu See, Chia-Chi Chung, Meng-Lin Yang, Chi-Chun Lai, Wei-Chi Wu
      Purpose To compare structural differences in the anterior chamber angle (ACA) and related optic components in children with or without retinopathy of prematurity (ROP). Design Prospective cross-sectional study. Methods Setting : A referred medical center in Taiwan. Study Population : The patients included preterm children with a history of ROP who had undergone laser therapy. The controls included age-matched healthy full-term children. Observation Procedure : The ACA structures were evaluated using gonioscopy. Main Outcome Measures : The angularity of the anterior chamber and associated anatomic changes. Results We examined 54 eyes of 29 preterm children with ROP and 134 eyes of 67 children born at term. The eyes of the ROP children exhibited a narrower ACA, steeper iris curvature, and more anteriorly inserted iris than those of the full-term children (P < .001, P = .002, and P = .08, respectively). The eyes of the ROP children also exhibited steeper corneas, shallower anterior chamber depths, thicker lenses, and higher degrees of refractive errors (all P < .001) than those of the full-term children. The axial lengths did not differ between the 2 groups (P = .15). Conclusions The eyes of the ROP children presented a narrower ACA and a more anteriorly curved and inserted iris than those of the full-term children. A steeper cornea, shallower anterior chamber, and greater lens thickness were the main structural changes in the anterior segment components of these patients. Further research is needed to investigate the association between these structural changes and the development of certain ocular diseases, such as glaucoma, in these patients.

      PubDate: 2017-05-12T15:23:25Z
      DOI: 10.1016/j.ajo.2017.04.010
      Issue No: Vol. 179 (2017)
       
  • Experience With a Subretinal Cell-based Therapy in Patients With
           Geographic Atrophy Secondary to Age-related Macular Degeneration
    • Authors: Allen C. Ho; Tom S. Chang; Michael Samuel; Paul Williamson; Robert F. Willenbucher; Terri Malone
      Pages: 67 - 80
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Allen C. Ho, Tom S. Chang, Michael Samuel, Paul Williamson, Robert F. Willenbucher, Terri Malone
      Purpose To evaluate the safety and tolerability of and clinical response to a single, subretinal dose of human umbilical tissue–derived cells (palucorcel [CNTO-2476]) in the eyes of adults aged ≥50 years with bilateral geographic atrophy (GA) secondary to age-related macular degeneration (AMD). Design Phase 1/2a, multicenter, open-label, dose-escalation, fellow-eye–controlled study. Methods In the phase 1 portion, eyes were assigned to receive a single, subretinal dose of palucorcel (ranging from 6.0 × 104 to 5.6 × 105 viable cells). In the phase 2a portion, eyes were assigned to one of 2 palucorcel doses (6.0 × 104 or 3.0 × 105 cells) determined during the phase 1 portion. The intervention eye was the eye with worse baseline visual acuity. Results A total of 35 eligible subjects underwent at least a partial surgical procedure. Palucorcel was administered in 33 eyes. Overall, 17.1% (6/35) of subjects experienced retinal detachments and 37.1% (13/35) experienced retinal perforations. No episodes of immune rejection or tumor formation were observed. At 1 year, ≥10- and ≥15-letter gains in best-corrected visual acuity were observed in 34.5% (10/29) and 24.1% (7/29) of eyes receiving palucorcel, respectively, and in 3.3% (1/30; for both) of fellow eyes. Conclusions The subretinal delivery procedure in this study was associated with a high rate of retinal perforations (n = 13) and retinal detachments (n = 6). When cells were sequestered in the subretinal space, palucorcel was well tolerated and may be associated with improvements in visual acuity. Larger randomized controlled studies are required to confirm these results. Future studies would require a modified surgical approach.

      PubDate: 2017-05-18T08:40:08Z
      DOI: 10.1016/j.ajo.2017.04.006
      Issue No: Vol. 179 (2017)
       
  • Sensitivity and Specificity of Laser-Scanning In Vivo Confocal Microscopy
           for Filamentous Fungal Keratitis: Role of Observer Experience
    • Authors: Ahmad Kheirkhah; Zeba A. Syed; Vannarut Satitpitakul; Sunali Goyal; Rodrigo Müller; Elmer Y. Tu; Reza Dana
      Pages: 81 - 89
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Ahmad Kheirkhah, Zeba A. Syed, Vannarut Satitpitakul, Sunali Goyal, Rodrigo Müller, Elmer Y. Tu, Reza Dana
      Purpose To determine sensitivity and specificity of laser-scanning in vivo confocal microscopy (LS-IVCM) for detection of filamentous fungi in patients with microbial keratitis and to evaluate the effect of observer's imaging experience on these parameters. Design Retrospective reliability study. Methods This study included 21 patients with filamentous fungal keratitis and 24 patients with bacterial keratitis (as controls). The etiology of infection was confirmed based on the response to specific therapy regardless of culture results. All patients had undergone full-thickness corneal imaging by a LS-IVCM (Heidelberg Retina Tomograph 3 with Rostock Cornea Module; Heidelberg Engineering, Heidelberg, Germany). The images were evaluated for the presence of fungal filaments by 2 experienced observers and 2 inexperienced observers. All observers were masked to the clinical and microbiologic data. Results The mean number of images obtained per eye was 917 ± 353. The average sensitivity of LS-IVCM for detecting fungal filaments was 71.4% ± 0% for the experienced observers and 42.9% ± 6.7% for the inexperienced observers. The average specificity was 89.6% ± 3.0% and 87.5% ± 17.7% for these 2 groups of observers, respectively. Although there was a good agreement between the 2 experienced observers (κ = 0.77), the inexperienced observers showed only a moderate interobserver agreement (κ = 0.51). The LS-IVCM sensitivity was higher in patients with fungal infections who had positive culture or longer duration of the disease. Conclusions Although LS-IVCM has a high specificity for diagnosing filamentous fungal keratitis, its sensitivity is moderate and highly dependent on the level of the observer's experience and training with this imaging modality.

      PubDate: 2017-05-18T08:40:08Z
      DOI: 10.1016/j.ajo.2017.04.011
      Issue No: Vol. 179 (2017)
       
  • Measurement and Reproducibility of Preserved Ellipsoid Zone Area and
           Preserved Retinal Pigment Epithelium Area in Eyes With Choroideremia
    • Authors: Amir H. Hariri; Swetha B. Velaga; Aniz Girach; Michael S. Ip; Phuc V. Le; Byron L. Lam; M. Dominik Fischer; Eeva-Marja Sankila; Mark E. Pennesi; Frank G. Holz; Robert E. MacLaren; David G. Birch; Carel B. Hoyng; Ian M. MacDonald; Graeme C. Black; Stephen H. Tsang; Neil M. Bressler; Michael Larsen; Michael B. Gorin; Andrew R. Webster; SriniVas R. Sadda
      Pages: 110 - 117
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Amir H. Hariri, Swetha B. Velaga, Aniz Girach, Michael S. Ip, Phuc V. Le, Byron L. Lam, M. Dominik Fischer, Eeva-Marja Sankila, Mark E. Pennesi, Frank G. Holz, Robert E. MacLaren, David G. Birch, Carel B. Hoyng, Ian M. MacDonald, Graeme C. Black, Stephen H. Tsang, Neil M. Bressler, Michael Larsen, Michael B. Gorin, Andrew R. Webster, SriniVas R. Sadda
      Purpose To identify valid and reproducible methods for quantifying anatomic outcome measures for eyes with choroideremia (CHM) in clinical trials. Design Reliability analysis study. Methods In this multicenter study, patients with confirmed genetic diagnosis of CHM were enrolled. All cases underwent spectral-domain optical coherence tomography (SDOCT) and fundus autofluorescence (FAF) imaging. Two graders independently delineated boundaries of preserved autofluorescence (PAF) and preserved ellipsoid zone (EZ) on FAF and OCT images, respectively. The results of the 2 independent gradings of both FAF and OCT images were compared to assess the reproducibility of the grading methods. Results A total of 148 eyes from 75 cases were included. In 21% of eyes PAF and in 43% of eyes preserved EZ had extended beyond the image capture area. After exclusion of these eyes and low-quality images, 114 FAF and 77 OCT images were graded. The mean PAF areas from 2 independent gradings were 3.720 ± 3.340 mm2 and 3.692 ± 3.253 mm2, respectively. Intraclass correlation coefficient (ICC) for these gradings was 0.996. The mean preserved EZ areas from 2 independent gradings were 2.746 ± 2.319 mm2 and 2.858 ± 2.446 mm2, respectively. ICC for these gradings was 0.991. Conclusions Quantifying preserved retinal pigment epithelium and EZ areas on FAF and OCT images, respectively, in CHM patients is highly reproducible. These variables would be potential anatomic outcome measures for CHM clinical trials and could be studied and tracked longitudinally in choroideremia.

      PubDate: 2017-05-28T09:03:54Z
      DOI: 10.1016/j.ajo.2017.05.002
      Issue No: Vol. 179 (2017)
       
  • Geographic Atrophy and Foveal-Sparing Changes Related to Visual Acuity in
           Patients With Dry Age-Related Macular Degeneration Over Time
    • Authors: Ramzi Gilbert Sayegh; Stefan Sacu; Roman Dunavölgyi; Maria Elisabeth Kroh; Philipp Roberts; Christoph Mitsch; Alessio Montuoro; Margit Ehrenmüller; Ursula Schmidt-Erfurth
      Pages: 118 - 128
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Ramzi Gilbert Sayegh, Stefan Sacu, Roman Dunavölgyi, Maria Elisabeth Kroh, Philipp Roberts, Christoph Mitsch, Alessio Montuoro, Margit Ehrenmüller, Ursula Schmidt-Erfurth
      Purpose To correlate the area of geographic atrophy (GA) and residual foveal sparing (FS), and to identify the minimum FS and maximum GA area allowing sufficient visual acuity (VA) for daily tasks. Design Prospective cohort study. Methods Thirty-six eyes of 25 patients with GA and FS were followed for 18 months using spectral-domain optical coherence tomography and VA tests. Volume scans were imported into software enabling grading of areas in B-scans and computing of planimetric measurements in complete volume scans. Correlation of areas 1 (complete atrophy), 2 (FS in the central millimeter), and 3 (FS in the central 3 mm) with each other and with best-corrected VA (BCVA) were evaluated. Results Baseline means of areas 1, 2, and 3 were 6.15 mm2, 0.49 mm2, and 3.08 mm2, respectively. At 1 year, area 1 increased by a mean of 1.33 mm2, while areas 2 and 3 were decreased by 0.12 mm2 and 0.65 mm2, respectively. From baseline to 18 months and from visit to visit, all areas and BCVA changed progressively (P < .001). Significant thresholds in GA size and FS for achieving a BCVA ≥ 70 ETDRS letters were detected (area 1: ≤6 mm2; area 2: ≥0.48 mm2; and area 3: ≥3.28 mm2). Conclusion GA and FS changed inversely over time. In general, FS highly correlated with BCVA, while GA progression correlated with the central 3-mm FS regression, but not with BCVA. A threshold in GA and FS area could be determined for BCVA necessary for daily activity.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.03.031
      Issue No: Vol. 179 (2017)
       
  • Long-term Visual Acuity, Strabismus, and Nystagmus Outcomes Following
           Multimodality Treatment in Group D Retinoblastoma Eyes
    • Authors: Ido D. Fabian; Zishan Naeem; Andrew W. Stacey; Tanzina Chowdhury; Catriona Duncan; M. Ashwin Reddy; Mandeep S. Sagoo
      Pages: 137 - 144
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Ido D. Fabian, Zishan Naeem, Andrew W. Stacey, Tanzina Chowdhury, Catriona Duncan, M. Ashwin Reddy, Mandeep S. Sagoo
      Purpose To analyze the long-term visual acuity, strabismus, and nystagmus outcomes in Group D retinoblastoma following multimodality treatments in a national retinoblastoma referral center. Design Retrospective interventional case series. Methods A 13-year retrospective chart review of Group D eyes treated initially with intravenous chemotherapy (IVC) and followed up for at least 1 year from last treatment. Risk factors for final visual acuity (VA) were analyzed, and rate of strabismus and nystagmus at last follow-up visit were calculated. Results One hundred and four Group D eyes (92 patients) presented to our center during the study period, of which 32 (27 patients) met the inclusion criteria. Following IVC (vincristine, etoposide, and carboplatin), adjuvant treatments included intraophthalmic artery chemotherapy in 5 (16%) eyes, plaque brachytherapy in 5 (16%), transpupillary thermotherapy (TTT) in 18 (56%), and cryotherapy in 24 (75%) eyes. On last examination, 64.41 ± 6.76 months from presentation, mean final VA was 20/283 (logMAR equivalent of 1.15 ± 0.15). On univariate analysis, presentation age, foveal retinoblastoma (at initial examination), use of TTT, and tumor–foveola distance (at last visit) were found to be significant risk factors for worse VA (P < .026). On multivariate analysis, however, only TTT was found to be significant (P = .010). At last visit, 6 of 27 (22%) patients had nystagmus and 12 of 20 (60%) bilaterally salvaged patients had strabismus (n = 10 exotropia and n = 2 esotropia). Conclusions After multimodality treatments initiated with IVC, 50% of salvaged Group D retinoblastoma eyes had <20/200 vision, with TTT being a risk factor for worse vision; 60% had strabismus; and 22% had nystagmus.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.003
      Issue No: Vol. 179 (2017)
       
  • Establishing a Regional Glaucoma Physician Collaborative to Improve
           Quality of Care
    • Authors: Joshua R. Ehrlich; Jeffrey N. Wentzloff; Nauman R. Imami; Taylor S. Blachley; Joshua D. Stein; Paul P. Lee; Jennifer S. Weizer
      Pages: 145 - 150
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Joshua R. Ehrlich, Jeffrey N. Wentzloff, Nauman R. Imami, Taylor S. Blachley, Joshua D. Stein, Paul P. Lee, Jennifer S. Weizer
      Purpose Improving adherence to practice guidelines can improve patient safety and quality of care. We sought to establish a regional glaucoma physician collaborative to evaluate and improve adherence to the American Academy of Ophthalmology's Primary Open-angle Glaucoma (POAG) Preferred Practice Pattern (PPP) guidelines. Design Prospective interventional study. Methods The collaborative consisted of 13 glaucoma specialists from 3 practices in Michigan. All consecutive POAG new patient visits were reviewed from each study site to determine physician adherence to the 13 major examination elements of the PPP. In phase 1 of the study, physician adherence rates for each of the recommended examination elements were combined and averaged for all groups. Averages for the collaborative were reported to each site, and each physician received his or her individual adherence rates. Physicians discussed strategies to improve overall adherence to the PPP. Adherence rates were collected in phase 2 to determine if feedback and sharing of strategies resulted in improved adherence. Results A total of 274 new POAG patient visits from phase 1 and 280 visits from phase 2 were reviewed. After accounting for multiple comparisons, overall improvement approached statistical significance for the evaluation of visual function (91.2% to 96.1%, P < .02) and target intraocular pressure determination (73.7% to 83.2%, P < .01). Improvement for other measures that had a high rate of adherence at baseline (eg, ocular history, pupil examination, and central corneal thickness measurement) was not statistically significant. Conclusions It is feasible to establish a regional glaucoma physician collaborative to improve standardization of care for patients with newly diagnosed POAG.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.04.022
      Issue No: Vol. 179 (2017)
       
  • Incidence of Intermediate-stage Age-related Macular Degeneration in
           Patients With Acquired Immunodeficiency Syndrome
    • Authors: Douglas A. Jabs; Mark L. Van Natta; Jeong Won Pak; Ronald P. Danis; Peter W. Hunt
      Pages: 151 - 158
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Douglas A. Jabs, Mark L. Van Natta, Jeong Won Pak, Ronald P. Danis, Peter W. Hunt
      Purpose To evaluate the incidence of intermediate-stage age-related macular degeneration (AMD) in patients with acquired immunodeficiency syndrome (AIDS). Design Cohort study. Methods Patients enrolled in the Longitudinal Study of the Ocular Complications of AIDS (LSOCA) underwent 5- and 10-year follow-up retinal photographs. Intermediate-stage AMD (AREDS stage 3) was determined from these photographs by graders at a centralized Reading Center, using the Age-Related Eye Disease Study-2 grading system. The incidence of AMD in LSOCA was compared with that in the Multi-Ethnic Study of Atherosclerosis (MESA), a Human Immunodeficiency Virus (HIV)-uninfected cohort, which used a similar photographic methodology. Results The incidence of AMD in LSOCA was 0.65/100 person-years (PY). In a multivariate analysis the only significant risk factor for AMD in LSOCA was smoking; the relative risk vs never-smokers was 3.4 for former smokers (95% confidence interval [CI] 1.3, 9.5; P = .02) and 3.3 for current smokers (95% CI 1.1, 9.7; P = .03). Compared with the MESA cohort, the race/ethnicity- and sex-adjusted risk of AMD in LSOCA was 1.75 (95% CI 1.16, 2.64; P = .008), despite the fact that the mean age of the MESA cohort was 17 years greater than the LSOCA cohort (61 ± 9 years vs 44 ± 8 years). Conclusions Patients with AIDS have a 1.75-fold increased race- and sex-adjusted incidence of intermediate-stage AMD compared with that found in an HIV-uninfected cohort. This increased incidence is consistent with the increased incidence of other age-related diseases in antiretroviral-treated, immune-restored, HIV-infected persons when compared with HIV-uninfected persons.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.004
      Issue No: Vol. 179 (2017)
       
  • Lower Laser Energy Levels Lead to Better Visual Recovery After
           Small-Incision Lenticule Extraction: Prospective Randomized Clinical Trial
           
    • Authors: Yong Woo Ji; Minseo Kim; David Sung Yong Kang; Dan Z. Reinstein; Timothy J. Archer; Jin Young Choi; Eung Kweon Kim; Hyung Keun Lee; Kyoung Yul Seo; Tae-im Kim
      Pages: 159 - 170
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Yong Woo Ji, Minseo Kim, David Sung Yong Kang, Dan Z. Reinstein, Timothy J. Archer, Jin Young Choi, Eung Kweon Kim, Hyung Keun Lee, Kyoung Yul Seo, Tae-im Kim
      Purpose To determine the effect of lowering laser energy on clinical outcomes in small-incision lenticule extraction (SMILE). Design Prospective randomized clinical trial. Methods A total of 151 patients (151 eyes) with moderate myopia scheduled for SMILE were included: 58 eyes received SMILE with low energy (100, 105, and 110 nJ; L-SMILE group) and 93 with conventional energy (115–150 nJ; C-SMILE group). Patients received complete ophthalmic examinations preoperatively and over 3 months postoperatively. Results Uncorrected distance visual acuity (logMAR UDVA) 1 day and 1 week postoperatively was significantly better in L-SMILE than in C-SMILE (P < .001 and P = .005, respectively). There was no significant difference between the groups at 1 and 3 months. L-SMILE induced significantly fewer corneal aberrations compared with C-SMILE at 1 week and 1 month postoperatively (both P < .01), but there were no significant differences at 3 months. Though there was no difference in logMAR UDVA over the postoperative period between the 100, 105, and 110 nJ subgroups, there was a significant difference in logMAR UDVA on postoperative day 1 between L-SMILE and each subgroup in which an energy level of 115 nJ or higher was used. Furthermore, logMAR UDVA on postoperative day 1 showed a significant correlation with laser energy (r = 0.451, P < .001) and multiple linear regression analysis revealed that energy level was the only independent factor associated with logMAR UDVA on postoperative day 1 (P < .001). Conclusions SMILE using femtosecond energy of less than 115 nJ facilitates better visual acuity with less induction of corneal aberrations in the early postoperative period.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.005
      Issue No: Vol. 179 (2017)
       
  • Objective Evaluation of Corneal and Lens Clarity in Children With Type 1
           Diabetes Mellitus
    • Authors: Kemal Tekin; Merve Inanc; Erdal Kurnaz; Elvan Bayramoglu; Emre Aydemir; Mustafa Koc; Zehra Aycan
      Pages: 190 - 197
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Kemal Tekin, Merve Inanc, Erdal Kurnaz, Elvan Bayramoglu, Emre Aydemir, Mustafa Koc, Zehra Aycan
      Purpose To investigate whether abnormal glucose metabolism and duration of diabetes mellitus (DM) affected the corneal and lens clarity in children with well-controlled type 1 DM and to compare the results obtained with those in healthy children. Design Cross-sectional prospective study. Methods This multicenter study enrolled 56 patients with DM and 51 control subjects. The duration of DM and the glycosylated hemoglobin (HbA1c) levels of the patients in the DM group were recorded. The Pentacam HR imaging system was used for corneal densitometry (12-mm corneal diameter) measurements. Furthermore, the lens densitometry and lens thickness (LT) measurements were performed after dilation of the pupils, using the same Pentacam HR device. Results The corneal densitometry values were similar in all concentric zones and layers in both groups (P > .05, for all). The mean values of the average and maximum lens densitometry measurements of the 2 groups, as well as the mean LT values, were statistically significantly different (P = .021, P = .011, and P < .001, respectively). There were statistically significant correlations between the lens densitometry values and the duration of DM (P < .05, for all). Conversely, no statistically significant relationship was found between the lens densitometry values and HbA1c levels (r = 0.743; P = .084). Conclusions The children with type 1 DM had decreased lens clarity and increased LT, even in cases of well-controlled DM, without DR. It is reasonable to think that these changes might have been caused by the type 1 DM.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.010
      Issue No: Vol. 179 (2017)
       
  • Determinants of Ocular Pain Severity in Patients With Dry Eye Disease
    • Authors: Vannarut Satitpitakul; Ahmad Kheirkhah; Alja Crnej; Pedram Hamrah; Reza Dana
      Pages: 198 - 204
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Vannarut Satitpitakul, Ahmad Kheirkhah, Alja Crnej, Pedram Hamrah, Reza Dana
      Purpose To quantify the severity of ocular pain in patients with dry eye disease (DED) and evaluate factors associated with pain severity. Design Cross-sectional study. Methods Eighty-four patients with DED were asked to score their severity level of ocular pain using a 10-point scale, with 10 indicating the most severe pain. All patients also had a comprehensive ophthalmic assessment including a detailed history, Ocular Surface Disease Index (OSDI) questionnaire, and ocular surface examination. Regression analysis was used to determine the factors associated with ocular pain severity. Results The mean OSDI score was 45.6 ± 23.1. At least some degree of ocular pain (score >1) was reported by 88.1% of patients, including mild pain (scores 2–4) in 46.4%, moderate pain (scores 5–7) in 34.5%, and severe pain (scores 8–10) in 7.1% of patients. Ocular pain levels significantly correlated with the OSDI score (rs = 0.49, P < .001). Regression analysis showed that the severity of ocular pain had a significant association with use of antidepressant medications (P = .045) but not with tear breakup time, corneal fluorescein staining, or ocular medications used by patients. In patients without pain, a significant correlation was seen between OSDI and corneal fluorescein staining scores (rs = 0.67, P = .01). However, such a correlation was not observed in those with ocular pain. Conclusions A majority of patients with DED report some degree of ocular pain, which correlates only moderately with the OSDI score. Severity of ocular pain correlates with nonocular comorbidities such as use of antidepressant medications rather than with clinical signs of DED.

      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.05.009
      Issue No: Vol. 179 (2017)
       
  • Concomitant Simple Limbal Epithelial Transplantation After Surgical
           Excision of Ocular Surface Squamous Neoplasia
    • Authors: Adriano Guarnieri; Javier Moreno-Montañés
      First page: 205
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Adriano Guarnieri, Javier Moreno-Montañés


      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.04.015
      Issue No: Vol. 179 (2017)
       
  • Insights Into Epiretinal Membranes: Presence of Ectopic Inner Foveal
           Layers and a New Optical Coherence Tomography Staging Scheme
    • Authors: Brijesh Takkar; Karthikeya R; Raghav Ravani; Ruchir Tewari
      Pages: 206 - 207
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Brijesh Takkar, Karthikeya R, Raghav Ravani, Ruchir Tewari


      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.04.016
      Issue No: Vol. 179 (2017)
       
  • Randomized Controlled Trial Evaluating a Standardized Strategy for Uveitis
           Etiologic Diagnosis (ULISSE)
    • Authors: Christopher T. Leffler; Vikram S. Brar; Michael Wallace
      Pages: 207 - 208
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Christopher T. Leffler, Vikram S. Brar, Michael Wallace


      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.04.020
      Issue No: Vol. 179 (2017)
       
  • Inferior Rectus Transposition a Novel Procedure for Abducens Palsy
    • Authors: Emin Cumhur Sener; Pinar Topcu Yilmaz
      Pages: 209 - 210
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Emin Cumhur Sener, Pinar Topcu Yilmaz


      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.04.025
      Issue No: Vol. 179 (2017)
       
  • Prevalence of Antiretinal Antibodies in Acute Zonal Occult Outer
           Retinopathy: A Comprehensive Review of 25 Cases
    • Authors: Farzin Forooghian
      Pages: 210 - 211
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Farzin Forooghian


      PubDate: 2017-06-22T09:38:55Z
      DOI: 10.1016/j.ajo.2017.01.036
      Issue No: Vol. 179 (2017)
       
  • Reply
    • Authors: Swathi Kaliki; Faraz Ali Mohammad Prerana Tahiliani Virender Sangwan
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Swathi Kaliki, Faraz Ali Mohammad, Prerana Tahiliani, Virender S. Sangwan


      PubDate: 2017-06-22T09:38:55Z
       
  • Reply
    • Authors: Andrea Govetto; Robert Lalane David Sarraf Jean Pierre Hubschman Marta
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Andrea Govetto, Robert A. Lalane, David Sarraf, Jean Pierre Hubschman, Marta S. Figueroa


      PubDate: 2017-06-22T09:38:55Z
       
  • Reply
    • Authors: Audrey Parisot; Yvan Jamilloux Laurent Kodjikian Errera Neila Sedira Emmanuel
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Audrey de Parisot, Yvan Jamilloux, Laurent Kodjikian, Marie-Hélène Errera, Neila Sedira, Emmanuel Heron, Laurent Pérard, Pierre-Loïc Cornut, Christelle Schneider, Sophie Rivière, Priscille Ollé, Grégory Pugnet, Pascal Cathébras, Pierre Manoli, Bahram Bodaghi, David Saadoun, Stéphanie Baillif, Nathalie Tieulie, Marc Andre, Frédéric Chiambaretta, Nicolas Bonin, Philip Bielefeld, Alain Bron, Frédéric Mouriaux, Boris Bienvenu, Stéphanie Vicente, Sylvie Bin, Christiane Broussolle, Evelyne Decullier, Pascal Sève


      PubDate: 2017-06-22T09:38:55Z
       
  • Reply
    • Authors: Federico Velez; Melinda Chang Stacy Pineles
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Federico G. Velez, Melinda Y. Chang, Stacy L. Pineles


      PubDate: 2017-06-22T09:38:55Z
       
  • Minimally Invasive Glaucoma Surgery: A Practical Guide, Brian A. Francis,
           Steven R. Sarkisian Jr, James C. Tan (Eds.). Thieme Publishers, New York
           (2017)
    • Authors: Nisha Nagarkatti-Gude; Steven Mansberger
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Nisha Nagarkatti-Gude, Steven Mansberger


      PubDate: 2017-06-22T09:38:55Z
       
  • The Building Blocks of Trabectome Surgery, Constance Okeke, MD, MSCE,
           Brian Francis, MD, Eydie Miller-Ellis, MD, Sameh Mosead, MD, Donald
           Minckler, MD (Eds.). Kugler Publications, Amsterdam, Netherlands (2017)
    • Authors: Louis Pasquale
      Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179
      Author(s): Louis R. Pasquale


      PubDate: 2017-06-22T09:38:55Z
       
  • Reporting Visual Acuities
    • Abstract: Publication date: July 2017
      Source:American Journal of Ophthalmology, Volume 179


      PubDate: 2017-06-22T09:38:55Z
       
  • Pseudophakic Macular Edema in Primary Open-Angle Glaucoma: a Prospective
           Study Using Spectral-Domain Optical Coherence Tomography
    • Authors: Kyoung Min Lee; Eun Ji Lee; Tae-Woo Kim; Hyunjoong Kim
      Abstract: Publication date: Available online 10 May 2017
      Source:American Journal of Ophthalmology
      Author(s): Kyoung Min Lee, Eun Ji Lee, Tae-Woo Kim, Hyunjoong Kim
      Purpose To determine the incidence of and risk factors for pseudophakic macular edema (PME) after uncomplicated cataract surgery in primary open-angle glaucoma (POAG) using spectral-domain optical coherence tomography (SD-OCT). Design Cohort study Methods Macular retinal thickness was evaluated using SD-OCT at 1-week before surgery and at 1-, 3-, 6-, and 12-months postoperatively, in 70 POAG and 68 control eyes. Forty-three healthy subjects without impaired vision or cystoid PME were recruited separately as pilot samples to define significant PME. Significant PME was defined as an increase in the average thickness exceeding the mean+three standard deviations of the increase shown in the pilot samples. Results Significant PME (increase in the foveal 3 mm-zone thickness of >19.5 μm) was observed in 31 (44%) eyes with POAG and in 14 (21%) control eyes (P=.003). The extent of PME was maximal at 3-months postoperatively and decreased gradually until 12-months. Regression tree analysis revealed that the risk of PME was the greatest in the POAG group using prostaglandin analogue (PGA) [odds ratio (OR)=5.51], followed by POAG not using PGA (OR=1.70), and control group (OR=1.0). Risk factors for PME was younger age in all groups (OR=1.07), systemic hypertension in PGA users (OR=6.42), higher untreated IOP in PGA nonusers (OR=1.09) and male sex (OR=14.06) and diabetes mellitus (OR=16.71) in control group. Conclusions The incidence of PME as observed by SD-OCT was higher than previously reported after uncomplicated cataract surgery. Eyes with POAG were at greater risk for PME, which was mainly associated with perioperative PGA use.

      PubDate: 2017-05-12T15:23:25Z
      DOI: 10.1016/j.ajo.2017.05.001
       
  • Relationship between internal reflectivity of diabetic microaneurysms on
           SD-OCT and detection on OCT Angiography
    • Authors: Mariacristina Parravano; Daniele De Geronimo; Fabio Scarinci; Lea Querques; Gianni Virgili; Joseph Michael Simonett; Monica Varano; Francesco Bandello; Giuseppe Querques
      Abstract: Publication date: Available online 5 May 2017
      Source:American Journal of Ophthalmology
      Author(s): Mariacristina Parravano, Daniele De Geronimo, Fabio Scarinci, Lea Querques, Gianni Virgili, Joseph Michael Simonett, Monica Varano, Francesco Bandello, Giuseppe Querques
      Purpose To correlate the appearance of Microaneurysms (MAs) on structural spectral-domain optical coherence tomography (SD-OCT) with their detection on OCT angiography (OCTA) in patients with non-proliferative diabetic retinopathy (NPDR). Design Inter-instrument reliability study. Methods Sixteen patients with NPDR without macular edema underwent SD-OCT and OCTA. To compare MAs seen on OCTA to those on SD-OCT, we superimposed the OCTA superficial capillary plexus (SCP) vascular landmarks onto those of the near infrared. Two observers blinded to patient groupings evaluated reflectivity of MAs on SD-OCT scans, graded as hypo-, moderate, or hyper-reflective, and their visualization at the level of SCP and deep capillary plexus (DCP) on OCTA. Results Among 145 MAs imaged with SD-OCT, 47 (32.4%) appeared as hyperreflective, 71 (49%) as moderately reflective, and 27 (18.6%) as hyporeflective. After excluding 3 eyes (10 MAs) because of poor quality OCTA scans, 135 MAs were evaluated on OCTA; 76 (56.3%) were visible only in the DCP, 9 (6.7%) only in the SCP, 29 (21.5%) were visible in both SCP and DCP; 21 (15.6%) were not visible on OCTA. Compared to MAs with hyper or moderate reflectivity, MAs with hypo reflectivity on structural SD-OCT were significantly less likely to be detected on OCTA (OR: 4.6; 95% CI: 1.5-14.0, p = 0.008; and OR: 4.2, 95% CI 1.2-14.2, p = 0.022, respectively). Conclusions MAs that appear hyporeflective on structural SD-OCT have a lower detection rate on OCTA. The results of this study may help further understand the different blood flow dynamics pattern in MAs.

      PubDate: 2017-05-07T15:15:31Z
      DOI: 10.1016/j.ajo.2017.04.021
       
  • Quality of Life Outcomes from a Randomized Clinical Trial Comparing
           Antimetabolites for Intermediate, Posterior, and Panuveitis
    • Authors: Katherine M. Niemeyer; John A. Gonzales; Sivakumar R. Rathinam; Manohar Babu; Radhika Thundikandy; Anuradha Kanakath; Travis C. Porco; Erica N. Browne; Maya M. Rao; Nisha R. Acharya
      Abstract: Publication date: Available online 14 April 2017
      Source:American Journal of Ophthalmology
      Author(s): Katherine M. Niemeyer, John A. Gonzales, Sivakumar R. Rathinam, Manohar Babu, Radhika Thundikandy, Anuradha Kanakath, Travis C. Porco, Erica N. Browne, Maya M. Rao, Nisha R. Acharya
      Purpose To evaluate the changes in quality of life in noninfectious uveitis patients treated with two of the most commonly prescribed antimetabolite treatments. Design Secondary analysis of a multicenter, block-randomized, clinical trial (ClinicalTrials.gov NCT01232920). Methods Eighty patients at Aravind Eye Hospitals in Madurai and Coimbatore, India, with noninfectious intermediate, posterior, or panuveitis were randomized to receive oral methotrexate, 25 mg weekly, or oral mycophenolate mofetil, 1 g twice daily, and were followed up monthly for 6 months. Best-corrected visual acuity, IND-VFQ, and SF-36 were obtained at enrollment and at 6 months (or prior in the event of early treatment failure). Results IND-VFQ scores, on average, increased by 9.2 points from trial enrollment to 6 months (95% CI: 4.9, 13.5, P =0.0001). While the SF-36 physical component summary score did not significantly differ over the course of the trial, the mental component summary score decreased by 2.3 points (95% CI: -4.4, -0.1, P=0.04) and the vitality subscale decreased by 3.5 points (95% CI: -5.6, -1.4, P=0.001). Quality of life scores did not differ between treatment arms. Linear regression modeling showed a 3.2 point improvement in IND-VFQ score for every 5 letter improvement in visual acuity (95% CI: 1.9, 4.3; P<0.001). Conclusions Although uveitis treatment was associated with increased vision and vision-related quality of life, patient-reported physical health did not change after 6 months of treatment, and, mental health decreased. Despite improved visual outcomes, uveitis patients receiving systemic immunosuppressive therapy may experience a deterioration in mental health-related quality of life.

      PubDate: 2017-04-18T08:54:10Z
      DOI: 10.1016/j.ajo.2017.04.003
       
 
 
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